Rotator cuff conditions are very common, affecting two to four million or people in the United States every year. Most people who have a rotator cuff injury can recover with rest and physical therapy. However, more serious injuries, such as complete rotator cuff tears, may require surgical repair.
The rotator cuff of the shoulder is made up of four muscles. Tendons of these muscles come together to form a covering around the head of the upper arm bone (humerus) and top of the shoulder. The rotator cuff muscles are important stabilizers and movers of the shoulder joint. As the name implies, the rotator cuff functions to allow you to rotate your shoulder and lift your arm.
Common rotator cuff injuries include rotator cuff tendonitis and rotator cuff strain, which is a partial or complete tear of the rotator cuff.
Rotator cuff tendonitis is inflammation or irritation in the tendons and cuff muscles that help move your shoulder joint. This injury typically occurs over time, usually as a result of keeping your shoulder in a single position for a prolonged period (such as sleeping on your shoulder every night), by overhead work-related activities, or athletic activities such as tennis, baseball, cricket or jai alai.
A rotator cuff tear may be partial or complete. A partial tear is when one of the tendons of the rotator cuff is frayed or damaged. A complete tear (also called a full-thickness tear) is when the tendon in is severed in half or pulled completely off of the bone.
Rotator cuff tears often occur over time from prolonged wear and tear. However, the rotator cuff may also be acutely injured by trauma involving a fall on the arm and shoulder or from heavy lifting. (It is common among weightlifters.) A dislocated shoulder injury may also cause a torn rotator cuff.
Rotator cuff tendonitis is the inflammation or irritation of the tendons and muscles in the shoulder joint. Symptoms of rotator cuff tendonitis typically get worse over time. These symptoms may include:
Symptoms of a partial or complete torn rotator cuff may include:
A doctor will first take the patient’s medical history and perform a physical examination to:
When diagnosing a shoulder cuff injury, a doctor will also rule out conditions that can cause similar symptoms, such as a compressed nerve in the neck (called a "pinched nerve") or shoulder arthritis.
The treatment for rotator cuff tendonitis includes first reducing swelling and inflammation then strengthening muscles and improving range of motion. Treatments may include:
All of the above treatments are usually followed by supervised physical therapy to regain shoulder motion and strength.
Mild rotator cuff tears may be treated nonsurgically with anti-inflammatory medication, steroid injections and/or physical therapy. However, for more severe tears or for active individuals who engage in sports or overhead work, surgery is often recommended.
A partial or complete tear of the rotator cuff tendon is generally repaired by arthroscopic surgery. Open surgery (using a larger incision) may be necessary for large, complicated full tears of the rotator cuff.
When, years after a rotator cuff tear, a person develops severe shoulder arthritis, they my benefit from a surgery called reverse shoulder replacement.
The minimum recovery time for rotator cuff tendonitis is generally two to four weeks. Left untreated, rotator cuff tendonitis can worsen and may lead to a partial or complete rotator cuff tear.
Symptoms of a partial or complete rotator cuff tear can last from several weeks up to several months depending on the severity of the injury and the treatment plan.
You should see an orthopedic surgeon or sports medicine doctor if pain from a rotator cuff injury is affecting your daily life, waking you up from sleep or reducing your range of motion. Make an appointment to see a doctor if:
Get more detailed information on rotator cuff injuries and treatments from the articles and other content below, or find a sports medicine doctor or surgeon at HSS suits your particular condition and insurance.
Find articles and videos on surgical and nonsurgical treatments for rotator cuff injuries.
The below articles are intended for primary care physicians and other medical professionals, but may also be of interest to patients.